Outlook: Obesity Epidemic

Allergy Suppressant or Appetite Stimulant?

A potential side effect of OTC and prescription antihistamines could sabotage weight-loss attempts, according to a new report by the American College of Preventive Medicine. In “Medications as Modifiable Contributors to Weight Gain,” Ingrid Kohlstadt, MD, MPH, advocates greater awareness of antihistamines as appetite stimulants and potential contributors to obesity.

According to Dr. Kohlstadt, histamines increase the potency of the hormone leptin, which plays a key role in regulating body weight and suppressing appetite. When medications block histamines to suppress allergic response, leptin’s primary function is also compromised. The result can spell disaster for dieters, whose appetites may increase without apparent reason.

“From a public health perspective, educating patients about the appetitestimulating potential of antihistamines can help guide their selection of overthe- counter medications,” Dr. Kohlstadt said. Pharmacists who offer counseling on these potential effects could help patients choose alternative approaches to allergy relief.

By simply being aware of the cause behind their increased appetite, patients who continue taking antihistamines may also come to view weight-loss challenges in a different light.

Recovery Act Delivers on Community Health Promise

The government gave communities a boost last month in the form of $372.8 million to support public health initiatives. As part of the Communities Putting Prevention to Work (CPPW) program, the awards will bolster the efforts of 44 communities to develop local infrastructure that encourages healthy behaviors.

Large and small cities, rural areas, and Native American tribes were among those selected to receive the funds. Projects are unique to the communities they serve, but they share a common goal: to reduce chronic disease and improve health through better public policy. Of the 44 funded initiatives, 23 will focus on preventing obesity; 14 on discouraging the use of tobacco; and 7 on both obesity and tobacco efforts.

In a statement accompanying the release of the funds, federal officials emphasized the program’s cost-saving properties. “Creating environments that promote health is a best buy for the American public,” said Thomas Frieden, MD, MPH, director of the Centers for Disease Control and Prevention. “Without aggressive efforts to prevent and control chronic diseases, the rise in health care costs will continue unchecked.”

CPPW is a component of the 2009 American Recovery and Reinvestment Act, which dedicates a total of $450 million to community-based health initiatives. For more information, visit www. cdc.gov/chronicdisease/recovery/ community.htm.

Obesity Linked to Death Risk for Colon Cancer

Obese patients with colon cancer face a significantly higher risk of death or relapse compared with those who maintain a normal weight, according to findings reported in the journal Clinical Cancer Research. The link was stronger in men than in women, perhaps due in part to the tendency of men to carry abdominal fat, researchers suggest.

The study followed 4381 adults who received chemotherapy treatment for stage II or III colon cancer. After 8 years, 42% of participants had died, and 36% experienced a relapse. Of the 787 normal-weight men who participated in the study, 53% were still alive after the 8-year period, compared with only 42% of men whose body mass index was 35 or higher. Obesity did not emerge as a critical risk factor among women with colon cancer, however.

The authors of the study say more research is needed to determine whether obesity itself is an independent risk factor, or if the higher mortality rate of obese colon cancer survivors can be attributed to other factors, such as heart disease, stroke, or poor nutrition and lack of exercise.

For Overweight Women, Moderate Exercise Doesn’t Cut It

Overweight women in their 50s may have to work harder than their normalweight peers to avoid adding pounds, a recent study suggests. Published March 24, 2010, in the Journal of the American Medical Association and funded by the National Institutes of Health, the report aimed to provide clarity on national recommendations for exercise, but ended up raising more questions.

The study followed 34,079 healthy, middle-aged women (mean age 54.2 years) for a 13-year period to examine the link between different levels of physical activity and long-term weight gain. Participants did not substantially cut calories or follow a strict diet. Researchers focused on moderate-in— tensity exercise, such as brisk walking, and divided the women into 3 groups according to the number of minutes they exercised weekly. Weight change was recorded in 3-year intervals.

On average, the women gained 6 lb throughout the course of the study. The results did link physical activity to less weight gain, but only in women whose baseline body mass index was already in the “normal” range—lower than 25. Approximately 13% of the women involved in the study successfully maintained a normal weight by engaging in 60 minutes of moderate exercise daily. For women who were overweight or obese, no relationship was found between levels of activity and weight gain. ■